Therapeutic approaches to obesity and metabolic syndrome in children and adolescents

Sochung Chung

doi:10.5124/jkma.2018.61.10.599

J Korean Med Assoc > Volume 61(10); 2018 > Article

Chung: Therapeutic approaches to obesity and metabolic syndrome in children and adolescents

Focused Issue of This Month

Pediatric endocrine disorders in Korea

Journal of the Korean Medical Association 2018; 61(10): 599-606.

Published online: October 22, 2018

DOI: http://dx.doi.org/10.5124/jkma.2018.61.10.599

Therapeutic approaches to obesity and metabolic syndrome in children and adolescents

Sochung Chung, MD

Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

Corresponding author: Sochung Chung. scchung@kuh.ac.kr

Received September 04, 2018 Accepted September 18, 2018

Korean Medical Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The prevalence of obesity and metabolic syndrome in children and adolescents continues to increase worldwide. Childhood obesity is associated with adulthood obesity and increases the risk of developing adult metabolic syndrome. Metabolic syndrome is a well-documented risk factor for cardiovascular disease and type 2 diabetes mellitus. Thus, to prevent cardiometabolic complications in later life, early detection and early interventions in obese children and adolescents are critical. In this review article, various methods of assessing obesity, including anthropometry and body composition analysis in children and adolescents, are introduced, and clinical predictive risk factors for metabolic syndrome in obese children and adolescents are described. With a comprehensive understanding of each risk factor in pediatric metabolic syndrome, treatment strategies for each component of metabolic syndrome are presented. Finally, the need to establish a school-hospital linkage system for the prevention and treatment of obesity and metabolic syndrome in children and adolescents is discussed.

Child; Adolescent; Obesity; Metabolic syndrome; Body composition

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Table 1

Definition of the risk group and metabolic syndrome in children and adolescents

NCEP-ATP, National Cholesterol Education Program Adult Treatment Panel; WC, waist circumference; TG, triglycerides; HDL-C, high-density lipoprotein-cholesterol; BP, blood pressure; SBP, systolic blood pressure; DBP, diastoilic blood pressure; FPG, fasting plasma glucose; T2DM, type 2 diabetes mellitus.

^a)Metabolic syndrome cannot be diagnosed, but further measurements should be made if there is a family history of metabolic syndrome, T2DM, dyslipidemia, cardiovascular disease, hypertension and/or obesity. ^b)For clinical purposes, but not for diagnosing the Metabolic syndrome, if FPG 100 to 125 mg/dL and not known to have diabetes, an oral glucose tolerance test should be performed